Ultrasonic dissector

ABSTRACT

An ultrasonic surgical instrument for dissection and coagulation of tissue is provided. The surgical instrument includes a vibration coupler supported within a housing and operably connected to an ultrasonic generator. An angled blade member is connected to the distal end of the vibration coupler to conduct high frequency vibration from the ultrasonic generator to the blade member. A clamp member is positioned adjacent to the blade member and is movable from a first position to a second approximated position. The clamp member and angled blade member combine to enhance contact between the tissue and the blade member during operation of the instrument to improve the performance of the instrument.

BACKGROUND

[0001] 1. Technical Field

[0002] The present disclosure relates to an ultrasonic instrument forsurgical use. More specifically, the present disclosure relates to anultrasonic instrument having an angled blade member and a clamp memberparticularly suited for use in performing dissection and coagulation oftissue.

[0003] 2. Background of Related Art

[0004] Ultrasonic instruments for surgical use and the benefitsassociated therewith are well known. For example, the use of anultrasonic generator in conjunction with a surgical scalpel facilitatesfaster and easier cutting of organic tissue and accelerates blood vesselclotting in the area of the cut, i.e., accelerated coagulation. Improvedcutting results from increased body tissue to scalpel contact caused bythe high frequency of vibration of the scalpel blade with respect tobody tissue. Improved coagulation results from heat generated by contactbetween the scalpel blade and the body tissue as the scalpel blade isvibrated at a high frequency. Thus, in order to reap the advantagesassociated with ultrasonic energy, good blade to tissue contact isimportant.

[0005] U.S. Pat. No. 3,862,630 (“Balamuth”) discloses an ultrasonicsystem including an ultrasonic motor, a tool member having a workingsurface oriented normal to the direction of mechanical vibrationgenerated by the ultrasonic motor, and a clamp member extending parallelto the tool member for compressing tissue against the tool member. U.S.Pat. No. 5,322,055 (“Davison”) discloses an ultrasonic surgicalinstrument adapted for endoscopic use having a blade and a clamp movablein relation to the blade to capture tissue therebetween. The blade andthe clamp define a clamping region having a plane which is parallel tothe longitudinal axis of the surgical instrument. During an endoscopicprocedure, movement of the instrument is limited to movement along anaxis parallel to the plane of the clamping region. Thus, no additionalblade force is imposed on the body tissue as a result of movement of theinstrument.

[0006] Accordingly, a need exists for an improved ultrasonic surgicalinstrument which is easy to use and provides fast and easy cutting andimproved coagulation.

SUMMARY

[0007] In accordance with the present disclosure, an ultrasonic surgicalinstrument is provided for dissection and coagulation of tissue. Thesurgical instrument includes a housing and a vibration coupler supportedwithin the housing operably connected to an ultrasonic generator. Anangled blade member is connected to the distal end of the vibrationcoupler to conduct high frequency vibration to the blade member. A clampmember may be positioned adjacent to the blade member and is movablefrom a first position to a second approximated position to capturetissue therebetween. The clamp member and angled blade member combine toenhance contact between the tissue and the blade member during operationof the instrument to improve the performance of the instrument.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Various preferred embodiments are described herein with referenceto the drawings, wherein:

[0009]FIG. 1 is a perspective view of one embodiment of the ultrasonicinstrument;

[0010]FIG. 2 is a side partial cross-sectional view of the ultrasonicinstrument shown in FIG. 1;

[0011]FIG. 2A is a side partial cross-sectional view of the proximal endof the ultrasonic instrument shown in FIG. 1 with the actuation rodbiased to its distal-most position;

[0012]FIG. 2B is a side partial cross-sectional view of the proximal endof the ultrasonic instrument shown in FIG. 1 further including a biasingand retaining mechanism wherein the actuation rod is retained in aretracted position;

[0013]FIG. 2C is a side partial cross-sectional view of the clamp memberand blade member of the ultrasonic instrument shown in FIG. 1 in theopen position;

[0014]FIG. 2D is a side partial cross-sectional view of the clamp memberand the blade member of the ultrasonic instrument shown in FIG. 1 in theclosed position;

[0015]FIG. 3 is a cross-sectional view taken along section line 3-3 ofFIG. 2;

[0016]FIG. 4 is a cross-sectional view taken along section line 4-4 ofFIG. 2C;

[0017]FIG. 4A is a cross-sectional view taken along section line 4A-4Aof FIG. 2D;

[0018]FIG. 5 is a side partial cross-sectional view of an alternateembodiment of the ultrasonic instrument;

[0019]FIG. 6 is a side partial cross-sectional view of the blade memberand clamp member shown in FIG. 5 with the clamp member in the openposition; and

[0020]FIG. 6A is a partial side cross-sectional view of the blade memberand the clamp member shown in FIG. 5 in the closed position.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] Preferred embodiments of the presently disclosed ultrasonicdissector will now be described in detail with reference to thedrawings, in which like reference numerals designate identical orcorresponding elements in each of the several views.

[0022] FIGS. 1-3 illustrate one embodiment of the presently disclosedultrasonic instrument shown generally as 10. Briefly, ultrasonicinstrument 10 includes a substantially cylindrical outer housing 12,preferably formed from molded housing half-sections, having an opendistal end 14 and a closed proximal end 16. The housing 12 may be formedwith a gripping member 17. The proximal end 16 of housing 12 is formedwith a slot 18 dimensioned to slidably receive an actuation rod 20 whichwill be discussed in further detail below. A remotely located ultrasonicgenerator 22 is electrically connected to a transducer 23 viaconventional means, such as a power cable 34. The transducer 23 issupported within the housing and engages a vibrator coupler 24 whichextends longitudinally towards the distal end 14 of housing 12. A blademember 26 having a cutting edge 32 is provided at the distal end of thevibration coupler 24. The blade member 26 is fixedly connected to thevibration coupler 24 or alternately integral therewith, such that thecutting edge 32 defines a plane oriented at an acute fixed angle,preferably from about 30 degrees to about 70 degrees, with respect tothe longitudinal axis of the instrument.

[0023] Ultrasonic generator 22 provides electrical energy havingultrasonic frequency to the transducer 23 to cause oscillation of thetransducer 23 in a known manner. The transducer 23, which may be one ofa variety of electromechanical types, e.g., electrodynamic,piezoelectric, magnetostrictive, is connected in end-to-end relation tothe vibration coupler 24 to cause oscillation of the vibration couplerand corresponding oscillation of angled blade member 26.

[0024] Actuation rod 20 is movably supported within housing 12 andextends from the proximal end of housing 12, via slot 18, through theopen distal end 14 of housing 12. Preferably, rod 20 is supported bybrackets 36 which may be integrally formed with housing 12, although anyconventional support structure which allows for linear movement of theactuation rod may be used. A proximal engagement surface 38 locatedexternally of the housing 12 facilitates selective advancement of theactuation rod 20. Clamp 28 is connected to the distal end of theactuation rod 20 and includes clamp surface 30 which is substantiallyparallel to and faces cutting edge 32 of blade member 26. The clamp 28is movable with respect to the blade member 26 from an open position toa closed position to capture tissue between the cutting edge 32 and theclamp surface 30. The clamp 28 may alternately be formed integral withthe actuation rod 20 and may have a smooth texture although a knurled orribbed surface may be provided to facilitate grasping of tissue or toenhance coagulation.

[0025] Referring to FIGS. 2A-2B, a biasing mechanism may be provided tobias the actuation rod 20 to a distal position and thus bias clamp 28 tothe closed position. The biasing mechanism includes an annular ring 31secured to or formed integrally with the is actuation rod 20 and abiasing spring 33. Biasing spring 33 is positioned about the actuationrod 20 between bracket 36 formed on housing 12 and annular ring 31 tocontinuously urge the actuation rod 20 distally. (See FIG. 2A.) Aretaining member 35 is pivotally secured within a slot 37 formed in thehousing and is pivotable into engagement with a rack 39 formed on theactuation rod 20. The retaining member 35 can be pivoted in thecounter-clockwise direction by moving slide member 41 proximally, asviewed in FIG. 2B, to selectively retain the clamp 28 at variouslocations between the open and closed positions. The slide member 41 maybe moved distally to disengage retaining member 35 from rack 37, asillustrated in FIG. 2A, to clamp tissue 50 between the clamp surface 30and the cutting edge 32.

[0026] In use, the ultrasonic instrument 10 is grasped about theproximal end of housing 12 and moved to position the cutting edge 32adjacent tissue to be dissected and/or coagulated. The actuation rod 20is retracted against the bias of spring 33 by pulling the engagementsurface 38 of actuation rod 20 to retract clamp 28 away from blade 26and provide access for tissue. In the open position, the clamp 28 isspaced from the blade member 26 a distance to permit easy tissue access.(See FIGS. 2C and 4.) When tissue 50 is positioned between clamp 28 andblade 26, engagement surface 38 is released to allow biasing spring 33to move clamp 28 to the closed position and to capture tissue 50therebetween. (See FIGS. 2D and 4A.) The actuation rod 20 may beretained in the retracted position while the instrument 10 is positionedabout tissue by pivoting retaining member 35 counter-clockwise intoengagement with rack 39 formed on actuation rod 20. (See FIG. 2B.)Clearly, other means to retain actuation rod 20 can be utilized. Theultrasonic generator 22 is energized to cause linear oscillation of theblade 26 with respect to the clamp 28 to effect dissection and/orcoagulation of tissue 50. Alternately, the actuation rod 20 may bebiased proximally to the open position so the clamp is biased to theopen position. In this alternate embodiment, a retaining means can beutilized to retain the clamp in the closed position.

[0027] FIGS. 5-6A illustrate a further embodiment of the presentlydisclosed ultrasonic dissector shown generally as 100. Ultrasonicdissector 100 is provided with a pivotable clamp 128. Briefly,ultrasonic dissector 100 includes a transducer 123 supported within ahousing 112 and adapted to be connected to an ultrasonic generator 122via power cable 134. The transducer 123 engages a vibration coupler 124having a blade member 126 rigidly attached, or alternatively integral,to the distal end of the coupler 124 therewith.

[0028] A clamp 128 is pivotably mounted to the distal end of housing 112about pivot member 119 such that clamp 128 extends through an opendistal end 114 of housing 112. Actuation rod 120 is supported onbrackets 136 for linear movement within housing 112. The distal end 121of actuation rod 120 is connected to a proximal end of clamp 128 via pin117 to translate linear advancement of the actuation rod 120 toclockwise rotation of clamp 128.

[0029] A thumb actuation member 138 is fixedly connected to actuationrod 120 by a link 143. The link 143 extends through slot 145 formed inhousing 112 to facilitate linear advancement of the thumb actuationmember 138 and corresponding linear advancement of the actuation rod120. A biasing mechanism for biasing the actuation rod to a proximalposition and a retaining mechanism to retain the actuation rod 120 in adistal position is shown in FIG. 5. Alternately, as discussed withrespect to FIG. 2, the actuation rod 120 may be biased distally tomaintain clamp member 128 in the closed position. In this alternateembodiment, a retaining member can be utilized to retain the clamp inthe open position.

[0030] More specifically referring to FIGS. 5-6B, clamp member 128 ofultrasonic instrument 100 is biased to the open position by biasingspring 133, which engages annular ring 131 to urge actuation rod 120proximally. After the instrument 100 is properly positioned abouttissue, actuation rod 120 may be advanced distally against the bias ofspring 133, via actuation member 138, to pivot the clamp member 128 intosubstantial alignment with blade member 126 and capture tissue betweenclamp surface 130 and cutting edge 132. (See FIG. 6A.) The retainingmember 135 may be pivoted clockwise to retain the clamp member 128 andblade member 126 in the closed position. Clearly, other means to retainthe clamp member 128 in the closed position can be utilized After tissueis captured between the clamp member and the blade member, theultrasonic generator 122 may be actuated to effect dissection and/orcoagulation of body tissue. As illustrated in FIG. 6A, the instrumentmay be moved proximally, during operation of the instrument, asindicated by arrow “B”, to increase the force applied by the cuttingedge 132 on body tissue 150.

[0031] It will be understood that various modifications may be made tothe embodiments disclosed herein. For example, different handleassemblies may be provided on the proximal end of the instrument toimprove gripping of the instrument, e.g., pistol grip. Also, the clampmember may be biased to the open or closed position. Therefore, theabove description should not be construed as limiting, but merely asexemplifications of preferred embodiments. Those skilled in the art willenvision other modifications within the scope and spirit of the claimsappended thereto.

What is claimed is:
 1. A surgical cutting instrument comprising: (a) avibration coupler adapted to be operably connected to an ultrasonicgenerator, the vibration coupler defining a longitudinal axis; (b) ablade member positioned adjacent a distal end portion of the vibrationcoupler, the blade member having a planar cutting surface disposed at afixed acute angle to the longitudinal axis of the vibration coupler; and(c) a clamp positioned adjacent the blade member, the clamp having atissue engaging surface movable between an open position spaced from theplanar cutting surface of the blade member and a clamped positionwherein the tissue engaging surface is moved towards the planar cuttingsurface.
 2. A surgical instrument according to claim 1, furtherincluding an actuation rod operably connected to the clamp, theactuation rod being movable to move the clamp between the first andsecond positions.
 3. A surgical instrument according to claim 1, whereinthe clamp is moved linearly from the open to the clamped position.
 4. Asurgical instrument according to claim 1, wherein the clamp is pivotedfrom the open position to the clamped position.
 5. A surgical instrumentaccording to claim 2 further comprising a biasing mechanism for biasingthe clamp member with respect to the blade member.
 6. A surgicalinstrument according to claim 5, further including a retaining mechanismto selectively retain the clamp at multiple locations between the firstand clamped positions.
 7. A surgical instrument according to claim 6,wherein the retaining mechanism includes a rack positioned on theactuation rod.
 8. A surgical instrument according to claim 7, whereinthe retaining mechanism further includes a retaining member movable intooperable engagement with the rack to retain the clamp in multiplelocations between the open and clamped positions.
 9. A surgicalinstrument according to claim 4, further including a housing, whereinthe clamp is pivotably secured to the housing.
 10. A surgical cuttinginstrument comprising: (a) a vibration coupler connectable to anultrasonic generator and defining a longitudinal axis; and (b) a blademember positioned adjacent a distal end portion of the vibration couplerand adapted to vibrate with the vibration coupler, the blade memberhaving a planar cutting surface disposed at an acute angle to thelongitudinal axis during vibration of the vibration coupler.
 11. Asurgical instrument according to claim 10, further including a clampmember, the clamp member being movable from an open position spaced fromthe cutting surface to a clamped position to capture tissue between theclamp and the cutting surface.
 12. A surgical instrument according toclaim 11, wherein the clamp member has a clamping surface, said clampingsurface being substantially parallel to the cutting surface when theclamp member is moved to the clamped position.
 13. A surgical instrumentaccording to claim 10, wherein the angle of the plane defined by thecutting surface of the blade member is from about 30 degrees to about 70degrees.
 14. A surgical instrument according to claim 11, wherein theclamp member is moved linearly from the open position to the clampedposition.
 15. A surgical instrument according to claim 11, wherein theclamp member is pivoted from the open to the clamped position.
 16. Asurgical instrument according to claim 10, further including anactuation rod operably connected to the clamp member, the actuation rodbeing movable to move the clamp member from the open to the clampedposition.
 17. A surgical instrument according to claim 11, furthercomprising a biasing mechanism for biasing the clamp member with respectto the blade member.
 18. A surgical instrument according to claim 17,further including a retaining mechanism to selectively retain the clampmember at multiple locations between the open and the clamped positions.19. A surgical instrument according to claim 18, wherein the retainingmechanism includes a rack operably associated with the actuation rod anda retaining member movable into engagement with the rack to selectivelyretain the clamp member at multiple locations between the open andclamped positions.
 20. A surgical cutting system comprising: (a) anultrasonic generator; (b) a vibration coupler operably connected to theultrasonic generator, the vibration coupler defining a longitudinal axisand being adapted to vibrate in response to actuation of the ultrasonicgenerator; (c) a blade member positioned adjacent a distal end portionof the vibration coupler, the blade member having a planar cuttingsurface disposed at a fixed acute angle to the longitudinal axis of thevibration coupler and being positioned to vibrate in response tovibration of the vibration coupler; and (d) a clamp positioned adjacentthe blade member, the clamp having a tissue engaging surface movablebetween an open position spaced from the planar cutting surface of theblade member and a clamped position wherein the tissue engaging surfaceis moved closer to the planar cutting surface of the blade member.
 21. Asurgical instrument according to claim 20, wherein the clamp is movedlinearly from the open to the clamped position.
 22. A surgicalinstrument according to claim 20, wherein the clamp is pivoted from theopen position to the clamped position.